Trends in tuberculosis incidence and their determinants in 134 countries
OBJECTIVE: To determine whether differences in national trends in tuberculosis incidence are attributable to the variable success of control programmes or to biological, social and economic factors. METHODS: We used trends in case notifications as a measure of trends in incidence in 134 countries, f...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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The World Health Organization
2009-09-01
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| Series: | Bulletin of the World Health Organization |
| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862009000900012&lng=en&tlng=en |
| _version_ | 1797283998715609088 |
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| author | C Dye K Lönnroth E Jaramillo BG Williams M Raviglione |
| author_facet | C Dye K Lönnroth E Jaramillo BG Williams M Raviglione |
| author_sort | C Dye |
| collection | DOAJ |
| description | OBJECTIVE: To determine whether differences in national trends in tuberculosis incidence are attributable to the variable success of control programmes or to biological, social and economic factors. METHODS: We used trends in case notifications as a measure of trends in incidence in 134 countries, from 1997 to 2006, and used regression analysis to explore the associations between these trends and 32 measures covering various aspects of development (1), the economy (6), the population (3), behavioural and biological risk factors (9), health services (6) and tuberculosis (TB) control (7). FINDINGS: The TB incidence rate changed annually within a range of ±10% over the study period in the 134 countries examined, and its average value declined in 93 countries. The rate was declining more quickly in countries that had a higher human development index, lower child mortality and access to improved sanitation. General development measures were also dominant explanatory variables within regions, though correlation with TB incidence trends varied geographically. The TB incidence rate was falling more quickly in countries with greater health expenditure (situated in central and eastern Europe and the eastern Mediterranean), high-income countries with lower immigration, and countries with lower child mortality and HIV infection rates (located in Latin America and the Caribbean). The intensity of TB control varied widely, and a possible causal link with TB incidence was found only in Latin America and the Caribbean, where the rate of detection of smear-positive cases showed a negative correlation with national incidence trends. CONCLUSION: Although TB control programmes have averted millions of deaths, their effects on transmission and incidence rates are not yet widely detectable. |
| first_indexed | 2024-03-07T17:41:43Z |
| format | Article |
| id | doaj.art-27b89b88e8d8495a974a0368702eafc2 |
| institution | Directory Open Access Journal |
| issn | 0042-9686 |
| language | English |
| last_indexed | 2024-03-07T17:41:43Z |
| publishDate | 2009-09-01 |
| publisher | The World Health Organization |
| record_format | Article |
| series | Bulletin of the World Health Organization |
| spelling | doaj.art-27b89b88e8d8495a974a0368702eafc22024-03-02T16:00:27ZengThe World Health OrganizationBulletin of the World Health Organization0042-96862009-09-01879683691S0042-96862009000900012Trends in tuberculosis incidence and their determinants in 134 countriesC Dye0K Lönnroth1E Jaramillo2BG Williams3M Raviglione4World Health OrganizationWorld Health OrganizationWorld Health OrganizationWorld Health OrganizationWorld Health OrganizationOBJECTIVE: To determine whether differences in national trends in tuberculosis incidence are attributable to the variable success of control programmes or to biological, social and economic factors. METHODS: We used trends in case notifications as a measure of trends in incidence in 134 countries, from 1997 to 2006, and used regression analysis to explore the associations between these trends and 32 measures covering various aspects of development (1), the economy (6), the population (3), behavioural and biological risk factors (9), health services (6) and tuberculosis (TB) control (7). FINDINGS: The TB incidence rate changed annually within a range of ±10% over the study period in the 134 countries examined, and its average value declined in 93 countries. The rate was declining more quickly in countries that had a higher human development index, lower child mortality and access to improved sanitation. General development measures were also dominant explanatory variables within regions, though correlation with TB incidence trends varied geographically. The TB incidence rate was falling more quickly in countries with greater health expenditure (situated in central and eastern Europe and the eastern Mediterranean), high-income countries with lower immigration, and countries with lower child mortality and HIV infection rates (located in Latin America and the Caribbean). The intensity of TB control varied widely, and a possible causal link with TB incidence was found only in Latin America and the Caribbean, where the rate of detection of smear-positive cases showed a negative correlation with national incidence trends. CONCLUSION: Although TB control programmes have averted millions of deaths, their effects on transmission and incidence rates are not yet widely detectable.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862009000900012&lng=en&tlng=en |
| spellingShingle | C Dye K Lönnroth E Jaramillo BG Williams M Raviglione Trends in tuberculosis incidence and their determinants in 134 countries Bulletin of the World Health Organization |
| title | Trends in tuberculosis incidence and their determinants in 134 countries |
| title_full | Trends in tuberculosis incidence and their determinants in 134 countries |
| title_fullStr | Trends in tuberculosis incidence and their determinants in 134 countries |
| title_full_unstemmed | Trends in tuberculosis incidence and their determinants in 134 countries |
| title_short | Trends in tuberculosis incidence and their determinants in 134 countries |
| title_sort | trends in tuberculosis incidence and their determinants in 134 countries |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862009000900012&lng=en&tlng=en |
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